Gluten and Health: What You Should Know

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Interview with Shelley Case, RD, Grain Foods Foundation

The New Year is coming and we all know what that means: Resolutions. Every year, scores of people resolve to reinvigorate their lives. Emerging from post-holiday traditional indulgences, food usually tops the list of resolutions made.

One of the fastest growing trends in food[2] in recent years is consuming a gluten-free diet. While some are seeking gluten-free options for legitimate dietary needs, others who do not have a diagnosed medical need (i.e. Celiac Disease[3], in which the intestinal villi, which absorb important nutrients, are damaged) are avoiding gluten without knowing what gluten is, its function in food, or whether eliminating gluten from the diet will improve their health. A recent video[4] by Jimmy Kimmel illustrated the low public understanding of gluten.

And despite common misperception, avoiding carbohydrates does not necessarily guarantee a gluten-free diet. To address these and other public misperceptions, Food Insight spoke with Shelley Case, RD, a Canadian nutrition expert on “gluten-free.”

FI: What is gluten?

SC: Gluten is a general term for a group of specific proteins called prolamins— storage proteins found in wheat, rye, and barley and related grains such as spelt, kamut, emmer, and faro.

Access Gluten Infographic[5]

FI: What are sources of gluten in the North American diet?

SC: The obvious sources of gluten that most people are familiar with are breads, pastas, cereals, and baked products. Additionally, the gluten-containing ingredients wheat flour, wheat starch, barley, and others can be used in foods like salad dressings, sauces (some soy sauces may include gluten*), marinades, prepared meats (e.g. breadcrumbs in hamburger patties), snack foods, seasonings, and candies (e.g. licorice and some chocolates).

* Some soy sauces may contain gluten, although monosodium glutamate, or MSG, does not.

FI: Who should be avoiding gluten and why?

SC: Those with Celiac Disease, a serious, inherited autoimmune disorder, must follow a strict gluten-free diet for life. Those with Non-Celiac Gluten Sensitivity (NCGS) also need to eliminate gluten. Many people say they feel better after going gluten-free. One reason for this may be that they were living with undiagnosed Celiac Disease—only about ten percent of those with Celiac Disease are actually diagnosed. If you suspect you may have Celiac Disease, it is essential to get tested before starting a gluten-free diet, as eliminating gluten can interfere with making an accurate diagnosis.

FI: What types of foods are naturally gluten-free?

SC: Although gluten is found in a wide variety of foods and beverages, there are numerous options for people who must avoid gluten. All of your fruits, vegetables, plain meats, fish, seafood, poultry, eggs, milk, yogurt, cheese, nuts, seeds, and legumes are all naturally gluten-free. There are also some gluten-free grain options, including amaranth, buckwheat, millet, quinoa, sorghum, teff, and all types of rice, even glutinous (aka “sticky”) rice. However, because of the potential for cross-contamination with gluten-containing grains, it is important for those who must avoid gluten to look for grains, flours, and starches that are labeled “gluten-free.”

FI: How do I know whether or not a food contains gluten?

SC: You need to look at the ingredients list and/or “Contains” statement on the food package for wheat, rye, barley, and other gluten-containing ingredients (The word “gluten” will not actually appear on the Nutrition Facts label or in the list of ingredients). In the US, the eight major allergens (including wheat, but not rye or barley) are required to be declared on the label.* In Canada, the top eight allergens and all gluten-containing ingredients must be declared on the label. Regardless of where you live, always check food labels if you need to avoid gluten.

FI: Are gluten-free foods more healthful than foods that contain gluten?

SC: This is a myth that I often hear. However, many gluten-free products are made with white rice flour and starches that are often not enriched. Also, they may contain more sugar and fat to increase palatability, and therefore be higher in calories than their gluten-containing counterparts. As a result, they can be lower in fiber, iron, and B vitamins. However, the market is growing and there are more options available today for those who must follow a gluten-free diet than ever before. Some manufacturers do enrich their products with vitamins and minerals, in addition to using other healthful ingredients to improve the nutrition profiles of these products.

FI: What is the most common myth you hear about gluten?

SC: Some best-selling authors have blamed gluten for every health condition. The fact is that nutrition and food is not that simple. Weight loss is a benefit often claimed with consuming a gluten-free diet, but ironically, many people gain weight when they eat a gluten-free diet. While some people may lose weight due to foregoing higher-calorie snack foods and eating more fruits, vegetables, and other nutritious foods, there’s nothing magical about going gluten-free.

FI: What is the most important thing that consumers should know about gluten?

SC: Those with Celiac Disease and NCGS should follow a gluten-free diet. However, for the vast majority of the population, there is no benefit to eliminating gluten. Rather, people should follow a healthful, varied diet.

FI: The scientific evidence demonstrates that there are no proven health benefits to avoiding gluten for those who do not have Celiac Disease or NCGS. The key is consuming fewer calories and getting regular physical activity. For those who have diagnosed Celiac Disease, it is important to avoid gluten and to understand the sources of gluten in order to identify them on food labels.

Shelley Case is a registered dietitian, speaker and author of the national best seller “Gluten-Free Diet: A Comprehensive Resource Guide.” She is a member of the Medical Advisory Boards of the Celiac Disease Foundation and Gluten Intolerance Group in the United States, the Professional Advisory Board of the Canadian Celiac Association, and the Grain Foods Foundation Scientific Advisory Board. Additional gluten-free resources can be found on her website, Glutenfreediet.ca[8].